Overgranulation (also commonly known as hypergranulation) is a common problem in chronic wound management. We describe a case involving a 57-year-old lady with a chronic diabetic foot ulcer, complicated with overgranulation for the past year. She was administered with various treatments, including hydrocortisone 1% cream and hydrofiber, which proved ineffective and further delayed the healing process of her ulcer. We then decided to use crushed Papase tablets applied to her ulcer after a normal saline dressing and prior to an application of secondary dressing. The patient was instructed clearly on the dressing technique to be performed daily at home and was monitored weekly in a foot care clinic. The overgranulation resolved within 5 weeks and the patient continues recieving care to promote epithelialisation.
STUDY DESIGN: Cross-sectional survey.
OBJECTIVES: To determine the employment outcomes of persons with spinal cord injury (SCI) and to investigate the impact of various demographic, injury-related and work-related variables on these outcomes.
SETTING: People living with SCI in Malaysia who are members of a disability support organization.
METHODS: A total of 84 members of the Malaysian Spinal Injury Association, who have had traumatic SCI for at least 2 years and were between 15 and 64 years of age at the time of study, were interviewed through phone using a questionnaire to identify the association between demographic, injury-related and work-related variables and employment outcomes.
RESULTS: The return to work rate in this study was 57.1% (employed at the time of study). The overall employment rate after SCI was 76.2% (worked at some point after injury). Those who were younger at time of injury (<20 years of age), able to drive a modified vehicle, independent in personal care and mobility were positively related to being employed. On the other hand, being hospitalized in the preceding 1 year and receiving financial incentives were negatively related to employment.
CONCLUSION: Functional independence, especially ability to drive, was strongly associated with return to work and should be one of the priority goals of comprehensive rehabilitation of persons with SCI. The negative impact of recent hospitalization as well as financial compensation needs to be probed further.
Transtibial prosthetic sockets can be fabricated either by the conventional way, which involve using plaster of Paris bandages for casting. This will include modifications through hand, scanning and digital imaging of software. The aim of this study is to determine the circumferential profiles and conduct a volumetric analysis of a conventional socket that has fabrication using biosculptor technology. In doing this, a male transtibial amputee, age 28 years old with stable health condition was studied, where circumferential measurements were taken at intervals of 1 cm from the distal end of the residual limb to the medial tibial plateau level. Furthermore, the interior volume of both sockets and residuum were determined directly using water displacement method. A comparative value for the calculation of volume was also carried out using engineering mathematical equations. From these measurements, a total surface bearing transtibial sockets was fabricated to compare the changes of circumferential values of both sockets. The finding shows a percentage of the difference between the volume of the residual limb and conventional sockets to be 6.09%, whereas the biosculptor fabrication socket was 7.84% using the water displacement method. A comparison of circumferential profiles and volumetric analysis findings on the contrary showed that socket fabricated using the biosculptor technology is interchangeable with the conventional socket with more advantages, where biosculptor technology produces cheaper sockets and faster process with digital function in the procedure, unlike the conventional manual technique.
Online gaming has greatly increased in popularity in recent years, and with this has come a multiplicity of problems due to excessive involvement in gaming. Gaming disorder, both online and offline, has been defined for the first time in the draft of 11th revision of the International Classification of Diseases (ICD-11). National surveys have shown prevalence rates of gaming disorder/addiction of 10%-15% among young people in several Asian countries and of 1%-10% in their counterparts in some Western countries. Several diseases related to excessive gaming are now recognized, and clinics are being established to respond to individual, family, and community concerns, but many cases remain hidden. Gaming disorder shares many features with addictions due to psychoactive substances and with gambling disorder, and functional neuroimaging shows that similar areas of the brain are activated. Governments and health agencies worldwide are seeking for the effects of online gaming to be addressed, and for preventive approaches to be developed. Central to this effort is a need to delineate the nature of the problem, which is the purpose of the definitions in the draft of ICD-11.
The proposed introduction of gaming disorder (GD) in the 11th revision of the International Classification of Diseases (ICD-11) developed by the World Health Organization (WHO) has led to a lively debate over the past year. Besides the broad support for the decision in the academic press, a recent publication by van Rooij et al. (2018) repeated the criticism raised against the inclusion of GD in ICD-11 by Aarseth et al. (2017). We argue that this group of researchers fails to recognize the clinical and public health considerations, which support the WHO perspective. It is important to recognize a range of biases that may influence this debate; in particular, the gaming industry may wish to diminish its responsibility by claiming that GD is not a public health problem, a position which maybe supported by arguments from scholars based in media psychology, computer games research, communication science, and related disciplines. However, just as with any other disease or disorder in the ICD-11, the decision whether or not to include GD is based on clinical evidence and public health needs. Therefore, we reiterate our conclusion that including GD reflects the essence of the ICD and will facilitate treatment and prevention for those who need it.